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8 Reasons You’re Always Cold

Some causes may be more serious than you think

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Certain medical conditions can cause your hands and feet to always feel chilled.
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Do you routinely crank up the heat in your home, much to the dismay of your family? Maybe you’re the one always reaching for a sweater when others around you are roasting?

There’s no denying that people run at different temperatures. But if you find that you are constantly chilly, even in warmer environments, a medical condition may be to blame. Keep reading to learn about eight health issues that can cause you to feel cold — plus, how aging can contribute to your feeling frosty.

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1. Anemia

According to the Centers for Disease Control and Prevention (CDC), almost 3 million people in the United States have anemia, a condition that occurs when you don’t have enough healthy red blood cells to deliver oxygen to the body’s tissues. As a result, it’s common to feel cold (especially in the hands and feet), tired and weak. Other warning signs of anemia include shortness of breath, pale or yellowish skin, an irregular heartbeat and headaches.  

Older adults — especially those over 65 — are among the populations more likely to develop a common type of anemia known as iron-deficiency anemia, according to the National Institutes of Health (NIH). Various factors — from diet to ulcers to blood disorders to cancer — can lead to anemia. A low-dose aspirin regimen may even play a role, according to a 2023 study published in the journal Annals of Internal Medicine. Researchers found that daily low-dose aspirin increases the risk of anemia in people 65 and older by approximately 20 percent. 

2. Type 2 diabetes

Diabetes, a chronic disease that affects how your body can turn food into energy, may cause you to feel cold, since it can affect blood flow and circulation. Diabetes can also lead to a condition known as peripheral neuropathy, which can cause a tingling feeling in your hands and feet. Up to half of people with diabetes have peripheral neuropathy, according to the NIH — that’s about 18.5 million Americans.

Risk factors for diabetes include being overweight, being 45 or older, lack of exercise and genetics.

3. Chronic kidney disease

Chronic kidney disease (CKD), which can be a complication of diabetes, occurs when the kidneys are damaged and cannot filter blood as well as they should. Feeling cold is an early sign of the condition, which affects some 37 million U.S. adults.

According to the Washington University School of Medicine in St. Louis, the symptom is a result of your kidneys failing to produce a hormone called erythropoietin, which regulates the production of red blood cells, leading to anemia.

4. Hypothyroidism (underactive thyroid)

The main role of your thyroid — a small, butterfly-shaped gland at the base of your neck — is to control the speed of your metabolism, the process of how your body transforms the food you eat into energy your body needs to function.

Hypothyroidism occurs when your thyroid doesn’t produce and release enough hormones, causing aspects of your metabolism to slow down. One of the more common symptoms of this condition, which affects nearly 5 percent of Americans age 12 and up, is a sudden sensitivity to cold. Other warning signs include fatigue, weight gain, joint and muscle pain and a slowed heart rate.

5. Heart failure

Congestive heart failure — or simply heart failure — is when the heart isn’t pumping blood as efficiently as it should. The condition can cause shortness of breath and a feeling of fatigue and weakness. It can also cause a person to feel cold.

“If [the heart is] not pumping out as much blood flow with each heartbeat, the body starts to compensate by kind of clamping down on the blood vessels in our extremities to try to help keep a good blood pressure throughout the body,” says Amy Pollak, M.D., a cardiologist at Mayo Clinic in Jacksonville, Florida. “Anything that drives the blood pressure to be really low” can cause someone to feel cold, she explains.

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More than 6 million people in the United States have congestive heart failure, which is the leading cause of hospitalization in people older than 65. Symptoms include chest pain, waking up short of breath at night, heart palpitations and swelling in the ankles, legs and abdomen.

6. Peripheral artery disease (PAD)

Peripheral artery disease (PAD) is a common circulatory problem in which narrowed arteries reduce blood flow to your limbs, typically the legs. Plaque buildup (fatty deposits and cholesterol) on the walls of the arteries restricts blood flow. If plaque breaks off and enters the bloodstream, clots can form, causing other problems, such as heart attack and stroke.

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A common symptom of PAD is muscle pain or weakness that begins with physical activity, such as walking, and stops within minutes after resting. Another warning sign is that one foot may feel colder than the other, according to the National Heart, Lung, and Blood Institute. The legs, feet and toes may appear pale, discolored or blueish.

“The most common area of peripheral arterial disease is in the legs, but it can happen anywhere — cerebrovascular, carotid, arms, kidneys, abdomen — you name it,” says Jay Varma, M.D., a vascular and interventional radiology specialist at Fairfax Vascular Center in Fairfax, Virginia.

The condition — which can be treated with lifestyle changes, medication and surgery, depending on the patient’s symptoms — is especially common among adults 50 and older.  

7. Raynaud’s disease

Raynaud’s disease is a disorder that causes the blood vessels in the extremities to narrow in response to coldness or stress. These narrowing “attacks” most often affect the fingers and the toes, causing them to feel icy and appear pale. When you warm up, the vessels expand again.

According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, scientists don’t know exactly what causes Raynaud’s. They do know that more women than men are affected by the phenomenon; genes may play a role, the institute says.

8. Medication complications

Some drugs may make you feel colder as a side effect, including beta-blockers used for heart disease. These blockers help the heart relax but may cause you to feel dizzy, tired, nauseous and colder in your hands and feet. Some ADHD (attention deficit/hyperactivity disorder) medications can cause you to feel cold and may lead to Raynaud’s, according to Mayo Clinic. Talk to your doctor if you suspect medication side effects are causing you to feel cold. He or she may be able to lower your dose or find an alternative medication.

Age-related changes can make you more prone to being cold

A few age-related changes can cause your internal thermostat to dip.

• Thinning of the skin. As we get older, the multilayered fat pads under the skin — the body’s insulation — get thinner, explains Sharon Brangman, M.D., a professor of medicine at SUNY Upstate Medical University in Syracuse and a past president of the American Geriatrics Society. “That’s why some people can see their veins and blood vessels so easily under the skin because that cushion thins out,” she says. “That insulation is gone, and your blood vessels are closer to your skin where they are more exposed to changes in temperature.”

• Brain changes. In the brain, the center that regulates body temperature — the hypothalamus, commonly called the natural thermostat — becomes less sensitive as we get older. The result: Your body may be slower at adjusting to changes in temperature.

 A slowing metabolism. “When you have a high metabolism, you’re often creating more energy, and that might also give you some background warmth,” Brangman says. “But as your metabolism slows down, there’s less energy being created, so you might feel cold.

“These are all a part of the normal changes that happen as we get older. It’s important to remember that aging is not a disease, it’s a natural state that everybody goes through,” Brangman says.

Editor's Note: This story, first published Feb. 23, 2018, has been updated to include new information, with additional reporting from Joyce Sampson.

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